What math is on the HESI A2? The topic checklist colleges publish
Written and reviewed by Brittany Scott, BSN, RN, CCM · 3 min read · Updated November 2026
Short answer
HESI A2 math covers arithmetic with whole numbers, fractions, decimals and percents, converting between them, ratios and proportions, basic algebra, household and metric measurement conversions, military time and Roman numerals. College guides list about 55 items, 50 scored, with 50 minutes recommended and a basic on-screen calculator.
The topic checklist
Texas State Technical College's HESI A2 guide (updated October 2026) lists these math topics: computation with whole numbers, decimals, fractions and percents; ratios and proportions; algebra; and measurement conversion. It describes the section as about 50 questions.
South Texas College describes the same section as basic math skills needed in health care, including addition, subtraction, multiplication, fractions, decimals, ratio and proportion, household measures and general math facts. South University's HESI math study guide adds worked material on military time and Roman numerals, which are worth your time even though the other lists do not name them.
The topics people skip
Most candidates study fractions and percents and then lose easy points on the odd items. Military time is one: South University's guide shows that 1945 hours is 7:45 pm, worked by subtracting 12 from the hour. Roman numerals are another, including subtractive forms such as CD for 400 and IX for 9.
Household measures are the third. South University's table lists 1 gallon equals 4 quarts, 1 quart equals 2 pints, 1 pint equals 2 cups and 1 cup equals 8 ounces. These are facts you either know or do not, and the calculator cannot supply them.
How many questions and how much time
South Texas College lists 55 math items, made up of 50 scored and 5 pilot items, with 50 minutes recommended. Tarrant County College (page updated August 2026) also lists 55 math questions with an on-screen calculator available, and Texas State Technical College gives roughly 50 questions.
Your program chooses which sections you take and may set its own time limits, so check the testing instructions your school or testing site sends after you register.
Is HESI A2 math hard?
The topics are basic arithmetic and measurement, but the cutoffs are high. Baylor University requires a math score of 80 or better, and South Texas College requires 75 percent on each section, so there is little room for careless errors.
The difficulty is usually setup, not arithmetic. Practice writing a ratio or proportion for each word problem before touching the calculator; if the setup is wrong, the calculator just gives you a wrong answer faster.
Sources
Texas State Technical College: HESI A2 study guide. Math topic list, basic on-screen calculator, about 50 questions (updated October 2026)
South Texas College: HESI Admission Assessment Info and FAQs. Math description, 55 items with 50 scored and 5 pilot, 50 minutes recommended, 75 percent cutoff
South University: HESI Math Study Guide. Military time, Roman numerals and household measure conversion table
Tarrant County College: HESI A2 exam information. 55 math questions with on-screen calculator (updated August 2026)
Baylor University School of Nursing: HESI A2 information. Minimum math score of 80
Common questions
How many math questions are on the HESI A2?
College guides list 55 math items, 50 scored and 5 unscored pilot items, with about 50 minutes recommended. Your program may set its own time limit.
Is there algebra on the HESI A2 math section?
Yes, at a basic level. Texas State Technical College lists algebra among its math topics, and South Texas College stresses ratio and proportion, so expect basic setups rather than advanced algebra.
Do I need to know dosage calculations for the HESI A2?
The college topic lists we checked describe general math, ratios and measurement conversion rather than clinical dosage formulas. Ratio and proportion skills are the foundation you need.